Paesmans M
Institut Jules-Bordet, Unité de Biostatistique, Bruxelles, Belgique.
Rev Mal Respir. 1994;11(6):547-57.
The interpretation of the results of a clinical trial, an experimental method now recognised as the agreed technique for studying new therapeutic modes of treatment in man, is based on a statistical study of data collected on a sample of patients enrolled in the study and treated till its fulfillment. This interpretation is often made using statistical inference techniques based on the construction of a decision rule associated with a statistical hypothesis test; this hypothesis test serves to formalize a research question in a precise manner, and allows the null hypothesis H0 to be tested against an alternative hypothesis H1. The decision rule will be constructed using a probability distribution, which assumes control against type I error, and consists of falsely rejecting the null hypothesis. However, the control of the risk of type II error, made error where one mistakenly takes a decision not to reject the null hypothesis, can only be achieved using a sufficiently large sample. The correct evaluation of the sample size is thus paramount if one does not wish to be doomed to the failure of a study, by including an insufficient number of patients to achieve the aimed objective. The aim of this report is to review how this evaluation can be due, in a practical manner without proof, in the context of simple situations which are used when Phase II or III clinical trials are put into action.
临床试验结果的解读基于对参与研究并接受治疗直至研究结束的患者样本所收集数据的统计分析,而临床试验是一种如今被公认为研究人类新治疗模式的商定技术。这种解读通常使用基于与统计假设检验相关的决策规则构建的统计推断技术;该假设检验用于以精确的方式将研究问题形式化,并允许对原假设H0与备择假设H1进行检验。决策规则将使用概率分布来构建,该概率分布假定对I型错误进行控制,I型错误是指错误地拒绝原假设。然而,对II型错误风险的控制,即错误地做出不拒绝原假设的决定,只能通过使用足够大的样本量来实现。因此,如果不想因纳入的患者数量不足而无法实现目标,从而注定研究失败,那么正确评估样本量至关重要。本报告的目的是回顾在II期或III期临床试验实施时所使用的简单情况下,如何在不进行证明的情况下以实际方式进行这种评估。